Curt Miller
In years past, most supply chain executives were more familiar with the things of “this world” – things they could touch, see, move – than those of the digital world. That’s no longer true, as today’s executives understand why marrying “things” with “data” can create efficiencies that their predecessors of 20 or 30 years ago couldn’t fathom.
Still, understanding phrases like “open data standards” can be challenging.
The Journal of Healthcare Contracting asked Curt Miller, executive director of the Committee for Healthcare e-Standards (CHeS), an arm of the Healthcare Supply Chain Association (HSCA), to explain the “down and dirty” of open data standards, and how they can improve the supply chain.
The Committee for Healthcare eStandards (CHeS) was formed in 2000 as a collaborative of organizations dedicated to promoting the adoption and use of open data standards in the healthcare industry. In 2008, CHeS joined and became part of HSCA, continuing its role as a leading advocate for the promotion of data standards within the healthcare supply chain.
CHeS has endorsed the adoption of the GS1 standards now being incorporated in the healthcare supply chain, including the Global Location Number™ (GLN™), the Global Trade Item Number® (GTIN®), and the use of the Global Data Synchronization Network® (GDSN®). CHeS also endorses the use of the United Nations Standards Products and Services Code® (UNSPSC®).
Curt Miller previously served as chief information officer for Amerinet Inc. (now Intalere), where for 10 years he was responsible for the company’s information systems strategy, application development, network infrastructure, data management, and unified communications.
Upon taking leadership of CHeS, Miller emphasized his commitment to helping the healthcare industry improve its accuracy, efficiency, and safety through the application of e-standards in the supply chain.
The Journal of Healthcare Contracting: The Committee for Healthcare eStandards defines itself as “a collaborative of organizations dedicated to promoting the adoption and use of open data standards in the healthcare industry.” What are some of the organizations that are involved?
Curt Miller: All members of the Healthcare Supply Chain Association are eligible to participate in CHeS. Current active members include HealthTrust, Intalere, Minnesota MultiState Contracting Alliance for Pharmacy, Premier, and Vizient. We also work with other organizations like GS1 to promote the adoption of data standards in the healthcare supply chain.
JHC: Can you name a couple of activities that CHeS has undertaken to “promote the adoption and use of open data standards?”
Miller: CHeS has been at the forefront of the healthcare supply chain standards effort and began researching best practices in 2000. That led to its endorsement of the Global Location Number (GLN) Registry in April 2004 and subsequent endorsements of Global Trade Item Numbers (GTINs), the Global Data Synchronization Network (GDSN) and the United Nations Standard Products and Services Code (UNSPSC).
CHeS has sponsored a number of work groups to track and support the implementation of standards such as the national GLN pilot program. Most recently CHeS collaborated with GS1 and the Healthcare Industry Supply Chain Institute (HISCI) to launch the Total Visibility Project, which identifies a standard set of product attributes that, when published to the GDSN, all HSCA members will accept as the minimum necessary to support their data needs.
JHC: CHeS has endorsed GS1 standards. What can/should each vice president of supply chain or director of materials be doing NOW to further the use of these standards?
Miller: First, supply chain leaders should get educated on how the GS1 standards can be used to improve effectiveness and efficiency in the healthcare supply chain and contribute to patient safety.
Second, if they have not yet done so, they should take ownership of and maintain their GLN hierarchy in the GS1 Data Hub. The GLN Data Hub was originally populated by the GPOs, however, each provider is now responsible for the ongoing maintenance of their information. GLNs are used to identify organizations and specific delivery locations, allowing all links in the supply chain – including manufacturers, distributors, exchanges and GPOs – to use a common identifier to refer to a specific location. GPOs and GS1 are prepared to assist in this process.
There is a wealth of information available on the GS1 GLN healthcare registry web page (https://www.glnregistry.org/healthcare). Providers should contact their GPO to get an editor password for the GLN registry and follow the Healthcare Provider GLN quickstart guide. Additional information, including case studies, is available on CHeS’s “It Takes Just One” resource page (http://www.supplychainassociation.org/?page=CHeS_Documents).
Third, supply chain leaders should be sure their materials management information system and other systems are GLN/GTIN-ready and begin populating and maintaining GTINs in those systems. Where and when possible, they should begin using GLNs and GTIN in transactions with trading partners.
Finally, supply chain leaders should be encouraging manufacturers to publish complete product information transparently to the GDSN, make complete catalogs accessible to all users and GPOs, and give preference to those suppliers who do so.
JHC: Big question: WHY should supply chain executives promote the use of open data standards? What’s in it for them?
Miller: Healthcare e-standards will allow for more efficient transaction processes with fewer errors. Standardized data and data protocols support automated transaction processes from procurement to payment. Fewer errors reduce the costs associated with manual interventions to resolve price discrepancies and contract price eligibility. Healthcare supply chains will also benefit from easier and improved data analytics and benchmarking. Instead of cleaning data, providers can better spend their time turning data into valuable information.
And patient safety will be improved through better ability to track recalls, lot numbers and product expirations through the systems.
JHC: In its December 2015 report to Congress, “Challenges and Barriers to Interoperability,” the Health Information Technology Policy Committee defines interoperability as “the ability of two or more systems to exchange information and the ability of those systems to use the information that has been exchanged without special effort.” Much of that report focused on the exchange of patient medical data among healthcare providers. What role, if any, do supply chain standards play in this larger picture?
Miller: The focus of the report was electronic health records. Supply chain information (primarily product data, lot numbers, unique identifiers, etc.) plays a significant role in interoperability. The Unique Device Identifier (UDI) contains the device identifier (DI) and production identifiers. The DI, which can be a Global Trade Item Number (GTIN), will be the connector between supply chain data and clinical data, and potentially, administrative data.
The benefits to the healthcare industry are numerous; however, patient safety, including improved adverse event reporting, reduction of medical errors, and enhanced management of product recalls, is cited as a key reason. The development of a National Medical Device Surveillance System to support device innovation is also enabled by connecting supply and clinical data using data standards. All systems should utilize the supply chain data standards already being adopted and work toward developing and implementing open standards for the balance of the information they exchange.
JHC: How can the National Medical Device Surveillance System support medical device innovation?
Miller: A robust postmarket surveillance system will link supply chain and clinical data. This will support timely and robust assessment of the risks and benefits associated with medical devices, and potentially expedite the approval of new devices and new uses for existing devices. A September 2012 FDA report, “Strengthening Our National System for Medical Device Postmarket Surveillance,” suggests that analysis of this data will foster innovation in the development of new technologies, new devices, and new uses for existing devices.
JHC: That same report listed many barriers and obstacles to interoperability, such as patient privacy laws, competitive threats, etc. What would you say are the primary obstacles or barriers to widespread adoption of supply-chain-related standards and interoperability?
Miller: The industry has come a long way from the days when CHeS was formed. We are in the process of actually implementing standards instead of just talking about them. Part of our current effort is trying to determine how to measure the extent of that adoption rather than just promote the standards. I find that progress encouraging.
I believe two big obstacles are slowing the pace of adoption – inertia and perceived risks. Inertia reflects the fact that despite less than ideal practices, most healthcare supply chain participants have in place a set of business processes and relationships that get their current needs taken care of, even if not as efficiently or effectively as they might wish. Changing a process or a data element within those processes requires additional effort and resources while the change is being made; that’s the learning curve. Organizations must be prepared to make an investment in resources to implement the changes.
Because these changes can impact multiple parties, those investments often must be made and coordinated by all the parties involved before the benefits can be fully realized. This takes time and increases potential risks.
The realization of benefits associated with the adoption of healthcare data standards is dependent upon the network effect. Once a critical mass of supply chain participants adopts and uses the standards, they will all begin to enjoy the benefits, and other players will then follow, increasing the benefits for all and ultimately encouraging still more to join in. The biggest risk is that the critical mass is never reached.
At this point, I believe the healthcare supply chain data e-standards effort has sufficient momentum to reach that critical mass – perhaps sooner, rather than later. To that end, CHeS is committed to working expedite the adoption and use of data standards.